An older patient reported to the clinic nurse that since a grandson moved in a few months ago, the patient has had problems sleeping. Which question by the nurse is most appropriate?
a. "How do you feel about having a room-mate?"
b. "Was it your decision to invite him to move in?"
c. "Has your sleep pattern changed since he moved in?"
d. "Can you be more specific about the trouble you have sleeping?"
C
The introduction of a new roommate often disrupts established sleep patterns, causing sleep dis-turbances. The nurse should also gather information on the specifics of the problem but should start with the event that the patient relates as the start of the issue.
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The nurse assessing a client for suicide potential will be most effective if she recognizes that the
cognitive style that places a client at increased risk is a. being flexible and interested in exploring alternatives. b. demonstrating tunnel vision thinking and perfectionism. c. demonstrating distractible, scattered thinking. d. The presence of strong religious beliefs.
Upon auscultation, the nurse hears a whooshing sound at the fifth intercostal space. The nurse recognizes that this sound is
a. The beginning of the systolic phase. b. The opening of the aortic valve. c. S3, the third heart sound. d. Regurgitation of the mitral valve.
A woman admitted through the emergency department delivered only 30 minutes after arriving at the hospital. She stated that her contractions had begun about 2 hours earlier and rapidly became more frequent and intense
Which statement best defines this brief labor? a. Because this was a precipitate labor, it could have resulted in fetal hypoxia or intracranial hemorrhage and maternal trauma. b. This was probably a postterm labor, which typically progresses very rapidly with little fetal or maternal risk. c. Hydramnios is a common cause of very rapid labor as a result of overdistention of the uterus. d. Women who have had previous cesarean births are at risk of uterine rupture following rapid labor.
A resource to assist nurses in developing an evidence-based nursing practice is
a. Healthy People 2010 b. Agency for Health Care Quality and Research c. American Nurses Credentialing Center d. American Medical Association